By: Savanah Craig
An important piece of treatment planning that I often overlooked at the start of my career was showing your patient the value of the treatment you are suggesting.
Patients do not always have the same understanding as I do about long-term outcomes. They look to me to explain and emphasize why treatment is necessary.
Additionally, patients may have different priorities than I do when it comes to their oral condition.
It is not my job to determine the best treatment plan for my patient, but it is important that I give them enough information to make an informed decision.
Examine & Diagnose
It takes time to pick up speed and confidence in your ability to examine a patient and properly diagnose.
In the beginning, I was so focused on charting everything I had noticed on an exam that explaining things to my patients became my secondary focus.
It was not uncommon to get through an examination and say to the patient “Miss Smith you need 5 fillings. Let’s get you scheduled!”
My patients would get confused at times. Their teeth didn’t hurt, nothing seemed wrong, so why did they need a filling.
I have since adopted the philosophy of telling the patient what problems I’ve noticed during my examination. Then, I provide the consequences of doing nothing.
Finally, I offer treatment solutions to this problem.
“Miss Smith during my examination I found that you have a cavity on this lower molar. Have you ever noticed food getting stuck in this area? If we do not fix the cavity in your tooth the decay will get larger and could eventually infect the nerve of your tooth. If that happens that tooth could require a root canal or an extraction. At this time, we can clean the decay out of the tooth and seal it with a traditional dental filling.”
Applying this foundation to my treatment planning gives the patient more information to make an informed decision and allows them to take ownership in the treatment they are selecting for themselves.
Patients Have Autonomy
Patients have autonomy and as dentists who abide by the ethical code of our profession, we must honor the decisions they make for their own health.
It is our job to inform the patient, to present risks and potential outcomes, and to provide them with a few options of well thought-out treatment plans. The patient then gets to make the decision on their treatment.
My mentor always says that treatments and procedures that are the biggest failures are when you want the treatment more than the patient.
Perhaps that missing #4 doesn’t bother the patient, but you really think an implant should be placed there. Those are the moments where you have to put aside your own opinions, values, priorities and listen to what the patient is telling you. You cannot want it more than the patient does.
They will be the one responsible for maintaining your work long-term and they will be the ones dealing with the consequences of a bad outcome.
Valuable Lessons I Have Learned
One of the most valuable lessons I have learned in providing value for patients is to reflect on what I would do in their shoes.
Every person is unique and will have a different level of value when it comes to various medical decisions in their life and teeth are no different.
Additionally, we may have different philosophies or priorities at different times of our lives. Financially, we may be in a different position today than we were a year ago and that is a factor that plays into decision making.
Dental care is expensive and often patients must choose a compromised solution due to finances.
Think about your own mouth for a moment. Say the lingual cusp of #30 fractured off at the bone level due nocturnal bruxism. Your treatment options may be buildup, crown, crown lengthening, or extraction and implant for example.
Which would you choose for your own mouth? How does your answer change based on how old you are when this happens? How does your financial situation at the time impact that decision? What if you were told that crown would only last 5 years?
All of these factors probably impact your decision. Our patients are no different, but they are looking to us to provide the value and context in which they make the best decision they can in the moment.
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Photo by Anna Shvets
